"I am a student at Columbia University. However, this comment to the Federal Trade Commission reflects my own personal opinions. This is not representative of the views of Columbia University or the Trustees of Columbia University." Telemedicine is an emerging avenue of medicine, with benefits and pitfalls. There is increasing use of telemedicine. Due to its inherent nature, telemedicine crosses both state borders and international borders. This lends to several regulatory issues, such as licensing issues and questions about medical malpractice coverage. It is imperative that these regulatory issues be addressed in order to eliminate barriers to the growth of telemedicine, and allow for better health care for patients. Both of the regulatory barriers can be addressed the same way. It is recommended that both licensing of practioners and medical malpractice insurance be regulated by the individual states. This is the best recommendation because telemedicine is a public health issue prominent at the state level. Individual states will have the most experience and expertise addressing such public health issues. It is acknowledged that states have a legitimate interest in protecting their patients and providing the best possible health care. Further, in issues of state versus federal regulation, precedence has been established for state regulation over federal regulation. States can enter into multi-state licensure programs, and multi-state insurance coverage. To have a blanket licensure or medical malpractice insurance may seem feasible, but it does not account for the different health care standards or different socioeconomic and political culture of different states. States should first limit that all telemedicine can only take place in the United States. This is to ensure that the quality of physicians and support staff are up to the standards of our state governments, and that all practioners are adequate insured. The following steps will be initiated: 1. Each individual state will create a department to regulate telemedicine. This subset will be responsible for telemedicine licensing, and insuring medical malpractice insurance for telemedicine. 2. Physicians must take qualifying telemedicine exams to practice medicine, this same standards should apply across the board in order to help standardize the quality of care that patients are receiving. States will work together to create a multi-state telemedicine licensing exam, that all telemedicine practioners will be required to pass to practice telemedicine. This will address issues of practioners not being licensed in the same state as the patient they are treating resided. Further it will allow states with similar practices and standards to continue to adhere to those standards. 3. All telemedicine practioners are required to carry a newly created multi-state or individual insurance that covers telemedicine liability issues. This will insure that all patients and practioners of telemedicine are adequately covered. By taking these steps we will be able to address the regulatory barriers to telemedicine, and insure that quality health care in the field of telemedicine occurs.